Tailbone Cancer - Symptoms, Diagnosis, and Treatment

Introduction:

Cancer is the abnormal growth of cells in any region. They can occur due to genetic structure changes that hamper a particular gene's function and risk factors like changes in the environment or lifestyle. The sole cause of cancer is still being researched. Tailbone cancer mainly shows up as tailbone pain, lower back pain, or an abnormal mass in the outer lower region of the spine. It affects even the basic sitting posture of the patient. Treatment for tailbone cancer includes effective surgery along with radiation therapy. Cure of the cancer is based on the extent of the cancer spread and the patient's clinical condition.

What Is Tailbone?

A spine (backbone) comprises a collection of 33 bones called the vertebrae. The last bony structure present in the spine is called the tailbone or coccyx. The bony triangular structure resembling a shortened tail located at the bottom of the spine below the sacrum is called the tailbone.

Three to five bony structures make up the tailbone. It is of two types depending on the fusion of bones in the tailbone.

• Fused coccyx.

• Separated coccyx.

The tailbone is connected to the bones of the spine by a joint.

What Are the Cancers of the Spine?

The spine or the backbone consists of the spinal cord, a continuous brain structure. The vertebrae are the bony structures protecting the spinal cord.

• Osteosarcoma: Cancer occurring in the bone cells of the spine.

• Chondrosarcoma: Rare cancer occurring in the bony cells, which can spread to surrounding soft tissues.

• Lymphoma: Cancer of the lymphatic system is called lymphoma.

• Chondroma: Cancer of the cartilage cells in the spine.

Depending on the location of the cancer, it can be -

• Intra- Dural Cancer: Lesions of cancer present inside the dura matter, which is the covering of the spinal cord, are called intra-dural cancers.

• Extradural Cancer: Tumors outside the dura matter or dural sac are called extradural cancers.

• Intra Medullary Cancer: The spinal cord's internal structure is called the medulla. Lesions present inside the medulla are called intramedullary cancers.

• Extra Medullary Cancer: Lesions or cancer cells outside the medulla are called extramedullary cancers.

What Is Tailbone Cancer?

The abnormal growth of cells in the coccygeal region (the last bony region of the spine) is called tailbone cancer. This cancer can also spread from elsewhere in the body, like lung cancer. Based on the formation and spread of tumors, tailbone cancer is divided into

• Primary Tumors: Tumors forming primarily at the region of the tailbone.

• Metastatic Tumors: Tumors are formed in other body parts and relocated to the tailbone.

Following are a few other types of tailbone cancer -

• Chordoma: Chordoma is a rare, life-threatening cancer of the tail bone which is lethal. It occurs in adults aged between 40 to 50 years.

• Sacrococcygeal Tumor: The presence of a well-defined tumor at the region of the sacrum and coccyx is called a sacrococcygeal tumor.

• Sacrococcygeal Teratoma: Abnormal growth of cancer cells in newborns' sacrum and coccyx region is called a sacrococcygeal teratoma.

What Are the Causes of Tailbone Cancers?

The exact cause of tailbone cancer is still being researched. Following are the risk factors that increase the occurrence of cancer -

• Lack of immunity.

• Genetics.

• History of cancer.

• Previous exposure to radiation therapy or chemotherapy.

What Are the Symptoms of Tailbone Cancer?

Tailbone cancer can show noticeable clinical changes such as the following.

• Coccydynia (pain in the tailbone).

• Headaches.

• Vision problems.

• Paralysis.

• Weakness and pain in the arms or legs.

• Palpable mass on the tailbone.

• Groin area numbness.

• Clumsiness or tingling sensation in legs.

• Bowel or bladder problems.

What Is the Diagnosis of Tailbone Cancer?

It is important to screen for tailbone cancer as it occurs at the sacrum or coccyx (the last bones of the spine) and is fatal after a few years of the diagnosis. Imaging techniques are carried out, like

• Ultrasound - Focused ultrasound is a non-invasive advanced technique used to detect metastatic cancers of the tailbone.

• Computed Tomography (CT) Scan - Computed tomography aims to visualize the tailbone structure digitally. Any disturbance in the joint or fractures.

• Magnetic Resonance Imaging (MRI) - MRI is a diagnostic method that uses a magnetic field to visualize the presence of abnormalities in the internal structure of the spine.

• Bone Scan - This diagnostic method helps detect any abnormality in bones by using radioactive material.

What Is the Treatment for Tailbone Cancer?

Staging cancer during diagnosis is important to follow a proper treatment plan. Treatment methods for tailbone cancer depend on the cancer stage and the patient's clinical condition to accept the treatments. The methods include

• Surgical Management - Surgical management is the best way to manage tailbone cancer. Following are the surgical procedures

  • Partial Coccygectomy - Removal of only the affected part of the coccyx.

  • Total Coccygectomy - Surgical removal of the entire coccyx bone.

Even though it is a difficult procedure, the patient is managed by well-experienced surgical oncologists. The only disadvantage of surgery is that certain normal tissues surrounding the tumor are also removed. In addition, performing the surgery without damaging any vital nerves or structures around the spinal cord is challenging.

• Nonsurgical Management - The following can manage cancers without surgery during the early stages -

  • Chemotherapy- Treatment using high-dose anti-cancer drugs.

  • Radiotherapy- Using radiation to kill any developing cancer cells.

  • Immunotherapy is a treatment aimed at increasing the patient's immunity to fight against cancer.

• A Combination of Surgical and Nonsurgical Management includes performing the required surgery and adjuvant radiotherapy. This is done to prevent any recurrences of cancer.

• Supportive Care - It is an integrated care that consists of the following:

  • Oncological rehabilitation.

  • Nutritional support.

  • Pain management.

  • Behavioral Health.

What Are the Side Effects of Tailbone Cancer?

Side effects of tailbone cancer include the following -

• Loss of pelvic bone stability.

• Leg weakness.

• Bowel and bladder control issues.

• Loss of sensation in the groin areas.

What Is the Prognosis of Tailbone Cancer?

Prognosis is the effect of a disease in the long run. Prognosis usually depends on factors such as -

• Location of the tumor.

• Spread of the tumor.

• Stage of cancer.

• Surgical response of the patient.

The patient's prognosis of tailbone cancer during the early stages of cancer is better than at later stages.

Conclusion:

Tailbone cancer mainly occurs in the lower spine region and can be misunderstood as normal lower back pain due to odd sitting posture. The higher the cancer staging, the greater the risk to the patient's life. Even though the cancer is highly lethal, tailbone cancer is usually diagnosed in its later stages. So, the condition needs to be diagnosed early so that oncologists and surgeons can efficiently manage it.